tbuckley/cabot-search huggingface dataset:
Abstract 18: Impact of Preeclampsia on Cardiovascular Risk Factors in Mothers and Newborns
Authors: Sofie Taageby Nielsen, Jesper Qvist Thomassen, Pia R Kamstrup, Borge G Nordestgaard, Anne-Sophie Sillesen, Anne Tybjaerg-Hansen, Henning Bundgaard, Kasper Iversen, Ruth Frikke-Schmidt
Journal: Circulation (2023)

Introduction: Preeclampsia is a multifactorial disease and a cause of maternal and neonatal morbidity and mortality. Women with preeclampsia have increased risk of cardiovascular diseases in later life. The impact on the offspring is, however, still uncertain. Lipid traits in newborns are considered to reflect the child’s own production. Hypothesis: We assessed the hypothesis that preeclampsia increases risk of future cardiovascular disease in both mother and offspring. Methods: For this purpose, we used the Copenhagen General Population Study comprising 59,571 women of which 1,365 had a diagnosis of preeclampsia to investigate the association between preeclampsia and risk of cardiovascular diseases. Further, we used the Copenhagen Baby Heart Study comprising more than 13,000 umbilical cord blood samples and assessed the impact of preeclampsia on atherogenic lipid traits in cord blood. Results: Age adjusted hazard ratios for preeclampsia versus no preeclampsia (95% CI) were 1.48 (1.13-1.94) for ischemic heart disease, 1.50 (1.07-2.12) for ischemic cerebrovascular disease, and 1.53 (1.22-1.91) for composite vascular disease. Corresponding multivariable adjusted hazard ratios (95% CI) were 1.31 (1.00-1.72), 1.44 (1.02-2.02), and 1.39 (1.11-1.74). Concentrations of non-HDL cholesterol, total cholesterol, LDL cholesterol, apolipoprotein B, and triglycerides in cord blood increased stepwise from no preeclampsia (n=11,221) to mild/moderate preeclampsia (n=253) to severe preeclampsia (n=104) (p for trends &lt;0.0001 for non-HDL cholesterol, total cholesterol and LDL cholesterol; p for trend=0.0002 for apolipoprotein B; p for trend=0.003 for triglycerides). Multivariable adjusted odds ratios (95% CI) for preeclampsia versus no preeclampsia (reference) for cord blood concentrations above the 80 th percentile were 2.09 (1.67-2.61) for non-HDL cholesterol, 1.58 (1.25-2.01) for total cholesterol, 1.72 (1.37-2.16) for LDL cholesterol, 1.38 (1.07-1.78) for apolipoprotein B, and 2.64 (2.07-3.35) for triglycerides. Conclusion: Women with preeclampsia had increased risk of future cardiovascular disease and lipid traits in umbilical cord blood of their offspring were elevated. This indicates that preeclampsia affects lipid metabolism during fetal life and potentially contributes to an increased risk of future cardiovascular disease in offspring of mothers with preeclampsia.
Abstract 42: Artificial Intelligence Electrocardiogram to Detect Coronary Calcification and to Predict Atherosclerotic Cardiovascular Events in the Community
Authors: Jose R Medina-Inojosa, Betsy J Medina-Inojosa, Zachi Attia, Michal Shelly, Abraham Baez Suarez, Paul Friedman, Rickey Carter, Francisco Lopez-Jimenez
Journal: Circulation (2023)

Background: We developed a deep learning algorithm that detects coronary artery calcium (CAC) score using 12-lead electrocardiograms (CAC- ECG). We tested the hypothesis that the output from the CAC-ECG algorithm would be associated with incident atherosclerotic cardiovascular disease (ASCVD) events and that the CAC- ECG would refine the AHA/ACC Pooled Cohort Equation’s (PCE) predictive capabilities. Methods: A community-based cohort of consecutive patients seeking primary care in Olmsted County, MN, between 1998-2000 with passive follow-up via record linkage. Inclusion was identical to the PCE. The original CAC-ECG was developed in 43,210 subjects yielding an AUC of 0.83. Herein, we used the CAC-ECG output to predict a high CAC (≥ 300). Primary outcome was ASCVD defined as fatal and non-fatal myocardial infarction and ischemic stroke, secondary outcome was Major Adverse Cardiovascular Events (MACE) further including PCI, CABG, and mortality. Events were validated in duplicate. Cox proportional hazard models adjusted for variables included in the PCE and were stratified to evaluate the effect of the CAC-ECG on PCE-predicted risk. Follow-up was truncated at 10 years for PCE analyses. Results: We included 24,793 subjects, mean ± SD age 53.9 ± 12.1, 52% women, 95% white. After 16.7±3.7 yrs follow-up, 2,366 (9.5%) had ASCVD and 3,401 (13.7%) had MACE. Risk of ASCVD and MACE increased with CAC-ECG probability quintiles, independent of risk factors, p for trend &lt;0.001 ( Fig. A-B ). The CAC-ECG enhanced the predicted capabilities of the PCE across all ASCVD risk groups ( Fig. C ). Net reclassification improved 13.7% with comparable C-statistic from 0.77 vs. 0.78 for PCE and CAC-ECG. Conclusions: CAC-ECG was associated with ASCVD and MACE and improved PCE predicted risk. The CAC-ECG algorithm could identify individuals at risk in primary prevention; Unlike the PCE, the CAC-ECG can be applied without chart review or performing a computer tomography and may be reliably used retrospectively in cohorts with digitally stored ECGs.
Abstract P173: Proteomic Assessment of Progressive Chronic Renal Insufficiency Risk and Mortality in a Heart Failure Community Study
Authors: Joseph J Shearer, Christine P Limonte, Kayode O Kuku, Jungnam Joo, Nicholas B Larson, Suzette J Bielinski, Veronique L Roger
Journal: Circulation (2023)

Introduction: Over six million U.S. adults have heart failure (HF). Evaluation of kidney function is critical to the care of patients with HF but may not be fully captured by traditional measures, such as estimated glomerular filtration rate (eGFR) or the Meta-Analysis Global Group in Chronic HF (MAGGIC) risk score. Identifying patients at highest risk of progressive chronic renal insufficiency (PCRI) may improve risk stratification in HF, beyond these traditional measures. High-throughput proteomics has allowed for the development of PCRI risk scores based on novel kidney function biomarkers. However, the prognostic value of a proteomic-based PCRI risk score in HF has not been explored. Hypothesis: Proteomic-based PCRI risk scores will improve risk stratification in HF. Methods: Clinical data and plasma were collected from 1,389 patients in a HF community cohort from Southeastern Minnesota (2003-2012). Results from the aptamer-based technology SomaScan® were used to derive PCRI risk scores using the SomaSignal™ Kidney Prognosis test, a protein-based algorithm developed to predict risk of PCRI within four years. Cox proportional hazard models were used to estimate the association between quintiles of PCRI and mortality, after adjustment for the MAGGIC score. Results: PCRI risk scores were available for 1,349 patients who were on average 75±13 years of age, 48% female, and had a median eGFR of 57 mL/min/1.73m 2 . There was a positive association with mortality across PCRI risk quintiles, after adjustment for the MAGGIC score. (Figure). Overall, the highest quintile was associated over a two-fold higher risk of mortality compared with the lowest quintile (HR 2.3, 95% CI 1.8,2.8). The higher risk of mortality remained in analyses stratified by patients with (HR 1.5, 95% CI 1.1,2.1) and without (HR 2.2, 95% CI 1.4,3.5) an eGFR &lt;60 mL/min/1.73 m 2 . Conclusions: In this community HF cohort, proteomic-based PCRI risk scores improve risk stratification, independent of traditional measures of kidney function.
Abstract P458: An Examination of the Influence of Daily Intersectional Minority Stressors on Sleep Health in Sexual and Gender Minority People of Color
Authors: Joseph Belloir, Ipek Ensari, Kasey Jackman, Shayna Feuer, Anisha Bhargava, Billy A Caceres
Journal: Circulation (2023)

Background: Sexual and gender minority (SGM; e.g., gay, lesbian, bisexual, transgender) people of color are at higher risk for poor sleep health outcomes than both White SGM adults and non-SGM people of color. Growing evidence suggests that chronic minority stressors (i.e., unique stressors attributed to one or more of an individual’s minoritized identities) are associated with short sleep duration and worse sleep quality in SGM adults. However, no study has examined the associations of daily intersectional minority stressors (i.e., attributed to any reason, such as race, sexual identity, gender) with sleep health outcomes in SGM people of color. Objective: To determine the associations of intersectional minority stressors (i.e., anticipated and experienced discrimination) with subsequent sleep health outcomes (i.e., sleep duration, sleep disturbances, and sleep-related impairment) at the day level among SGM people of color. Methods: An online sample of SGM people of color living in the United States participated in a 30-day daily diary study. Daily anticipated discrimination (i.e., expectation of encountering discrimination) and personally experienced discrimination as well as daily subjective sleep health outcomes were assessed using morning and evening electronic diaries. Daily anticipated and experienced discrimination were assessed using validated measures. Patient-Reported Outcomes Measurement Information System (PROMIS) 4-item measures were used to assess daily subjective sleep disturbances and sleep-related impairment. Continuous wrist-worn actigraphy was used to objectively assess sleep duration. Multilevel linear models (MLMs) were used to estimate the independent associations of daily intersectional minority stressors with subsequent sleep health outcomes, adjusted for demographic factors and chronic minority stressors. Results: The sample included 43 SGM people of color with a mean age of 27.0 years (+/- 7.7) of which 84% were Latinx, 47% were multi-racial, and 37% were bisexual. Results of MLMs indicated that greater report of daily experienced discrimination was positively associated with same-night sleep disturbances ( B[SE] = 0.33[0.12], p = 0.01). Further, daily anticipated discrimination was positively associated with sleep-related impairment on the following day ( B[SE] = 0.39[0.17], p = 0.02). However, daily anticipated and experienced discrimination were not associated with same-night sleep duration. Conclusions: This is the first study to simultaneously examine the influence of daily anticipated and experienced discrimination on sleep health in any population. Further research is needed to identify factors driving the link between daily intersectional minority stressors and subjective sleep health outcomes in SGM people of color. This work is crucial to inform precision sleep health interventions tailored for this population.
Abstract P305: Peripheral Neuropathy is Associated With Slow Gait Speed in Older Adults in the Atherosclerosis Risk in Communities Study
Authors: Katherine M McDermott, Dan Wang, Yein Jeon, Laura Skow, B Gwen Windham, Jennifer Schrack, Elizabeth Selvin, Caitlin W Hicks
Journal: Circulation (2023)

Introduction: Peripheral neuropathy (PN) (decreased sensation in the foot) is associated with falls and mortality. Small studies have found an association between slow gait speed and PN, primarily in adults with diabetes, but evidence is limited in adults without diabetes. Hypothesis: We hypothesized that PN is associated with slow gait speed in older adults. Methods: We performed a non-concurrent cross-sectional analysis of 360 participants in the Atherosclerosis Risk in Communities (ARIC) Study who completed standardized monofilament testing for PN at visit 6 (2016-2017) and Zeno Walkway mat-sensor gait testing at visit 8 (2019-2020). Gait speed was assessed categorically (normal (≥1.0m/s) or slow (&lt;1.0m/s)) and continuously. Logistic and linear regression were used to examine the association between PN and slow gait speed overall and stratified by diabetes status after adjusting for traditional risk factors. Results: The prevalence of PN was 32.2% (34% in adults with diabetes and 30% in adults without diabetes). Slow gait speed was observed in 53% of patients with PN compared to 40% of patients without PN (p=0.022). In adjusted models, PN was significantly associated with slow (categorical) and slower (continuous) gait speed in the overall sample, and these associations were particularly robust among adults without diabetes ( Table ). Conclusions: PN was associated with slow gait speed in a community-dwelling cohort of older adults. The specific association of PN and slow gait speed in persons without diabetes is novel. Despite a relatively small sample size, the difference between PN and non-PN participants’ continuous gait speeds exceeded the accepted threshold for clinically meaningful differences (generally &gt;0.05m/s). A better understanding of additional PN-specific gait changes may help elucidate mechanisms underlying the association of PN with slow gait, falls, and mortality.
Abstract P164: Using Mixed Methods to Assess Community Based Participatory Research Implementation: Assessment of a Walking-Based Health Intervention Program
Authors: Lindsay Spitz, Jennifer J Salinas, Roy Valuenzuela
Journal: Circulation (2023)

Introduction: The Border Coalition for Fitness (BCF) is a community-based organization sponsored by Texas Tech University Health Sciences Center El Paso(TTUHSC El Paso) that facilitates walking-based programs. These interventions aim to increase physical activity among a majority Hispanic population in El Paso, TX. To provide programming that effectively meets the community's needs, the BCF aims to operate within a community-based participatory research (CBPR) framework that centers on community engagement and the translation of research into tangible benefits to the community. This mixed methods assessment examines perceptions of the BCF and its impact on the community. Methods: For the quantitative study, depending on the self-selected group (BCF, community leader, or community participant), respondents completed either a leadership (BCF, community leaders) or non-leadership (community participants) questionnaire. Both assess perceptions on a scale from 0 to 10, 10 being the best, across three constructs: leadership(L), resources(R), and ability and commitment to organize(C). For the qualitative study, members of the BCF and former walking intervention participants completed one-on-one interviews consisting of 13 open-ended questions. Qualitative interviews are ongoing. Results: Preliminary results from the quantitative survey (n=103) show high ratings across stakeholder groups and constructs. BCF members consistently represent the highest ratings (L:9.6; R:9.6; C:9.3) across all constructs, followed by the community leaders (L:8.3; R:8.1; C:8.5), and finally, community participants (L:8.0; R:7.7; C:7.6). There is good agreement among BCF members (n=5) and community members (n=2) that the BCF has a strong collaborative relationship with its academic sponsor and the community and provides impactful programming. Areas cited for improvement included a need for more autonomy on the part of the BCF and improved understanding of and interaction with the BCF on the part of community members. Conclusion: In conclusion, early findings from this mixed-methods assessment indicate strong support for the BCF and its programming among leadership and the community. However, insight gained from the qualitative interviews highlights several areas of improvement in terms of community-based participatory research practices, particularly encouraging community engagement with the BCF beyond participation in the walking-based programs.
Abstract P157: Genetically Determine Gut Microbiome Abundance, Obese, and Incident Type 2 Diabetes
Authors: Rui Tang, Minghao Kou, Xiang Li, Xuan Wang, Hao Ma, Zhaoxia Liang, Yoriko Heianza, Lu Qi
Journal: Circulation (2023)

Introduction: Gut microbiota has been linked to the body’s adiposity and the development of type 2 diabetes (T2D). A recent genome-wide association study identified that genetic variants at the ABO locus (SNPs rs8176645 and rs550057) were associated with the abundance of gut microbiome (i.e., Bifidobacterium bifidum and Collinsella aerofaciens, respectively). Hypothesis: We assessed the hypothesis that the genetically determined gut microbiome abundance was associated with incident T2D, and such association could be modified by obese status. Methods: A total of 339,465 European ancestry participants who are initially free of T2D at baseline and have available information on genetic variants from the UK Biobank population were included in this study. The genetic risk score (GRS) was constructed by the risk alleles of the two genetic variants at the ABO locus. Cox proportional hazard models were used to estimate the associations between the genetic variants/GRS and incident T2D. Results: During a median of 11.8 years of follow-up, 11,566 incident T2D were documented. We observed that the gut microbiome-related variants rs8176645 and rs550057 were both significantly associated with incident T2D after adjustment for sex, age, body mass index (BMI), Townsend deprivation index, smoking, drinking, regular physical activity, and diet score at baseline (hazard ratio [HR] per copy of risk allele A of rs8176645 1.05, 95% CI [1.02-1.09], P -value=0.001; HR per copy of risk allele T of rs550057 1.06, 95% CI [1.03-1.09], P -value&lt;0.001; respectively). The GRS also showed a significant association with T2D incidence in the fully adjusted model (HR=1.03, 95% CI [1.01-1.05], P -value&lt;0.001). In addition, we found that BMI significantly modified the associations between GRS and T2D, which were more pronounced in non-obese participants ( P -interaction=0.008). Conclusion: Our findings indicate that the genetically determined gut microbiome abundance significantly predicts T2D risk, independent of traditional risk factors.
Abstract P216: Carbohydrate Quantity and Quality, and Risk of Type 2 Diabetes: Results From Three Large Prospective US Cohorts
Authors: Caleigh M Sawicki, Kim V Braun, Danielle E Haslam, Hala B Alessa, Walter C Willett, Frank B Hu, Shilpa N Bhupathiraju
Journal: Circulation (2023)

Background: High-quality carbohydrate sources, such as whole grains, have been associated with a lower risk of type 2 diabetes (T2D), whereas low-quality carbohydrate sources, such as refined grains and added sugar, have been associated with a higher T2D risk. However, few studies have considered how replacing dietary carbohydrate with other macronutrients may influence T2D risk. Objective: We examined whether isocaloric substitution of high- or low-quality carbohydrate for fat, protein, and their subtypes is associated with T2D risk. Methods: We included 75,430 women from the Nurses' Health Study (1984-2016), 85,630 women from the Nurses' Health Study II (1991-2017), and 40,261 men from the Health Professionals Follow-Up Study (1986-2016) who were free of T2D, CVD, and cancer at baseline. Dietary data were collected every 2-4 years using a validated, semi-quantitative food frequency questionnaire. High-quality carbohydrate was defined as carbohydrate from whole grains, fruits, vegetables, and legumes. Low-quality carbohydrate was defined as carbohydrate from refined grains, added sugars, and potatoes. We used Cox proportional hazards regression with time-varying covariates to model the substitution of 5% of energy intake from high- and low-quality carbohydrate for isocaloric amounts of fat, protein, and their subtypes [polyunsaturated fat (PUFA), animal and plant monounsaturated fat (MUFA), saturated fat, trans fat, and animal and plant protein]. Cohort-specific estimates were combined using inverse variance-weighted fixed effects meta-analyses. Results: During 4,859,845 years of follow-up, we documented 20,141 incident T2D cases. In multivariable-adjusted meta-analyses, isocaloric substitution of high-quality carbohydrate for total fat [HR (95% CI) 0.94 (0.93, 0.96)], total MUFA [0.95 (0.91, 0.98)], MUFA from animal sources [0.92 (0.88, 0.95)], total protein [0.91 (0.89, 0.94)], or animal protein [0.94 (0.91, 0.97] was associated with a lower T2D risk. On the other hand, the substitution of low-quality carbohydrate for plant MUFA [1.06 (1.02-1.10)] or plant protein [1.06 (1.02-1.11)] was associated with a higher risk of T2D. When we restricted high-quality carbohydrate sources to whole grains, the results were similar or stronger. Additionally, substitution of whole grain carbohydrate for saturated fat [0.87 (0.84, 0.91)], trans fat [0.87 (0.83, 0.92)], PUFA [0.88 (0.84, 0.92)], plant MUFA [0.92 (0.87, 0.96)], or plant protein [0.91 (0.86, 0.97)] was associated with lower T2D risk. Conclusions: The effect of carbohydrate substitution on T2D risk depends not only on the nutrient being substituted but also on the quality of the carbohydrate. Substitution of high-quality carbohydrate, especially carbohydrate from whole grains (i.e. whole wheat bread, oatmeal), for fat or protein, especially animal sources (i.e. beef, poultry), may lower T2D risk.
Abstract P254: Mental Well-Being of Caregivers With Overweight and Obesity is Associated With Cognitive Stimulation Provided to Children in the Home
Authors: Daphne Lew, Genevieve Davison, Colleen Kilanowski, Ihuoma U Eneli, Stephen R Cook, Teresa Quattrin, Kenneth Schechtman, Leonard Epstein, Denise Wilfley
Journal: Circulation (2023)

Introduction: Parents with poor mental health are less likely to engage in cognitively enriching parenting behaviors, such as reading and playing with their children. This, in turn, is associated with increased risk of obesity in the child and poor treatment outcomes for children enrolled in behavioral weight management. Parents and caregivers with obesity also have worse mental health and lower life satisfaction than their non-obese counterparts. Among parents with overweight and obesity who have a child with overweight/obesity, the relationship between parent mental health and cognitive enrichment provided in the home is unknown. Hypothesis: We hypothesize that higher depressive symptoms and lower subjective well-being scores among parents will be associated with less cognitive enrichment provided to children. Further, we hypothesize that these relationships will be moderated by the sex of the parent. Methods: This study was a secondary analysis of baseline data from 452 parent-child dyads with overweight/obesity enrolled in a family-based behavioral treatment study for obesity. Depression symptoms and subjective well-being were assessed using the Patient Health Questionnaire-9 scale and the MacArthur Scale of Subjective Social Status, respectively. Cognitive stimulation was measured with the Cognitive Stimulation subscale of the Environmental Enrichment scale. Univariable relationships were assessed using Pearson correlations. Multivariable linear regression models were used to control for study site, parent characteristics (age, BMI, sex, race/ethnicity, education), child characteristics (age, and sex), and family characteristics (health insurance status and household income). Results: Higher depression symptom score was correlated with lower cognitive stimulation (ρ = -0.165, p &lt; 0.001), whereas higher subjective well-being was associated with higher cognitive stimulation (ρ = 0.377, p &lt; 0.001). These relationships were maintained even after controlling for covariates in the multivariable models, with each one-unit increase in depression symptoms associated with a 0.16 unit decrease in cognitive stimulation (95% CI -0.27 to -0.06, p = 0.003) and each one-unit increase in subjective well-being associated with a 0.04 unit increase in cognitive stimulation (95% CI 0.01, 0.07, p = 0.01). Parent sex did not moderate these effects. Conclusions: Mental well-being of parents and caregivers with overweight/obesity is associated with the degree of cognitive enrichment provided to the child in the home, though the effect sizes after controlling for covariates were modest. Thus, interventions targeting parental wellbeing offer a potential avenue to improve their child’s cognitive wellbeing and response to obesity treatment.